切换至 "中华医学电子期刊资源库"

中华心脏与心律电子杂志 ›› 2024, Vol. 12 ›› Issue (04) : 193 -198. doi: 10.3877/cma.j.issn.2095-6568.2024.04.001

标准与规范

经皮心内膜心肌活检的操作流程及注意事项
岳鑫1, 张海锋2,(), 李新立1   
  1. 1.210029 南京,南京医科大学第一附属医院(江苏省人民医院)心血管内科
    2.215008 苏州,南京医科大学附属苏州医院(苏州市立医院)心血管病中心
  • 收稿日期:2024-05-09 出版日期:2024-12-25
  • 通信作者: 张海锋
  • 基金资助:
    国家自然科学基金(82270394,82200425,81970339)姑苏卫生人才计划(GSWS2021042)姑苏学院人才引进项目(GSRCKY20210204)

The operation procedure of percutaneous endomyocardial biopsy

Xin Yue1, Haifeng Zhang2,(), Xinli Li1   

  1. 1.Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing 210029, China
    2.Center of Cardiovascular Diseases, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Suzhou 215008, China
  • Received:2024-05-09 Published:2024-12-25
  • Corresponding author: Haifeng Zhang
引用本文:

岳鑫, 张海锋, 李新立. 经皮心内膜心肌活检的操作流程及注意事项[J/OL]. 中华心脏与心律电子杂志, 2024, 12(04): 193-198.

Xin Yue, Haifeng Zhang, Xinli Li. The operation procedure of percutaneous endomyocardial biopsy[J/OL]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2024, 12(04): 193-198.

经皮心内膜心肌活检最初用于监测心脏移植排斥反应的侵入性操作,通过心肌活检钳经外周血管进入右心室或左心室夹取心内膜心肌组织。近数十年,心肌活检技术不断更新,目前已成为一些心脏疾病诊断和评估的重要手段。本文结合相关文献,围绕其术前准备、操作要点、术后监测及术后并发症等方面进行阐述。

图1 经皮心内膜心肌活检技术历史进程
图2 现代心肌活检钳
表1 经皮心内膜心肌活检的常见并发症及罕见并发症
图3 经皮右心室心内膜心肌活检操作流程图
图4 经皮左心室心内膜心肌活检操作流程图
[1]
Sakakibara S, Konno S. Endomyocardial biopsy[J]. Jpn Heart J, 1962, 3: 537-543.
[2]
Weinberg M, Fell EH, Lynfield J. Diagnostic biopsy of the pericardium and myocardium[J]. AMA Arch Surg, 1958,76(5): 825-829.
[3]
Caves PK, Stinson EB, Graham AF, et al. Percutaneous transvenous endomyocardial biopsy[J]. JAMA, 1973,225(3):288-291.
[4]
Kawai C, Kitaura Y. New endomyocardial biopsy catheter for the left ventricle[J]. Am J Cardiol, 1977, 40(1):63-65.
[5]
Cooper LT, Baughman KL, Feldman AM, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology[J].Circulation, 2007, 116(19): 2216-2233.
[6]
Francis R, Lewis C. Myocardial biopsy: techniques and indications[J]. Heart, 2018, 104(11):950-958.
[7]
Seferović PM, Tsutsui H, McNamara DM, et al. Heart Failure Association of the ESC, Heart Failure Society of America and Japanese Heart Failure Society Position statement on endomyocardial biopsy[J]. Eur J Heart Fail,2021, 23(6): 854-871.
[8]
徐希奇, 田庄, 方全, 等. 北京协和医院经皮心内膜心肌活检临床操作规范[J]. 协和医学杂志, 2021, 12(3):322-327.
[9]
Porcari A, Baggio C, Fabris E, et al. Endomyocardial biopsy in the clinical context: current indications and challenging scenarios[J]. Heart Fail Rev, 2023, 28(1):123-135.
[10]
Patel IJ, Rahim S, Davidson JC, et al. Society of Interventional Radiology Consensus Guidelines for the periprocedural management of thrombotic and bleeding risk in patients undergoing percutaneous image-guided interventions-Part II: Recommendations: Endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe[J]. J Vasc Interv Radiol, 2019, 30(8):1168-1184.e1.
[11]
Harwani N, Chukwu E, Alvarez M, et al. Comparison of brachial vein versus internal jugular vein approach for access to the right side of the heart with or without myocardial biopsy[J]. Am J Cardiol, 2015, 116(5):740-743.
[12]
Schäufele TG, Spittler R, Karagianni A, et al. Transradial left ventricular endomyocardial biopsy: assessment of safety and efficacy[J]. Clin Res Cardiol, 2015, 104(9):773-781.
[13]
Thiene G, Bruneval P, Veinot J, et al. Diagnostic use of the endomyocardial biopsy: a consensus statement[J].Virchows Arch, 2013, 463(1):1-5.
[14]
Holzmann M, Nicko A, Kühl U, et al. Complication rate of right ventricular endomyocardial biopsy via the femoral approach: a retrospective and prospective study analyzing 3048 diagnostic procedures over an 11-year period[J]. Circulation, 2008, 118(17):1722-1728.
[15]
Chimenti C, Frustaci A. Contribution and risks of left ventricular endomyocardial biopsy in patients with cardiomyopathies: a retrospective study over a 28-year period[J]. Circulation, 2013, 128(14):1531-1541.
[16]
Deckers JW, Hare JM, Baughman KL. Complications of transvenous right ventricular endomyocardial biopsy in adult patients with cardiomyopathy: a seven-year survey of 546 consecutive diagnostic procedures in a tertiary referral center[J]. J Am Coll Cardiol, 1992, 19(1):43-47.
[1] 朱彩霞, 刘志兴, 谌芳群, 王婧玲, 姚谨, 彭星琦, 毛毅, 陈莉. 超声黏弹性成像技术对≤3 cm 乳腺肿块良恶性的鉴别诊断价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(12): 1095-1102.
[2] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[3] 夏靖涵, 林凤娇, 王胰, 丁戈琦, 张清凤, 张红梅, 谢盛华, 李明星, 尹立雪, 李文华. 二尖瓣空间变化联合左心房应变对肥厚型心肌病合并左心室流出道梗阻的预测价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 585-592.
[4] 王岚, 徐斌胜, 谢乐. 肥厚型心肌病的经胸超声心动图诊断与心电图表现特征[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 593-596.
[5] 熊鹰, 林敬莱, 白奇, 郭剑明, 王烁. 肾癌自动化病理诊断:AI离临床还有多远?[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 535-540.
[6] 谭雷, 王等娣, 张浩, 丹增卓玛, 龙怡, 吴泽倩. 超声造影在肝破裂诊断中的应用:一例西藏地区肝破裂引发的思考[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 113-117.
[7] 中华医学会器官移植学分会, 中国医师协会器官移植医师分会. 肝移植术后急性移植物抗宿主病诊疗中国专家共识(2024 版)[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 1-12.
[8] 王秋生. 胆道良性疾病诊疗策略[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 779-782.
[9] 贾玲玲, 滕飞, 常键, 黄福, 刘剑萍. 心肺康复在各种疾病中应用的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 859-862.
[10] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[11] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[12] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[13] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[14] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
[15] 胡云鹤, 周玉焯, 付瑞瑛, 于凡, 李爱东. CHS-DRG付费制度下GB1分组住院费用影响因素分析与管理策略探讨[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 568-574.
阅读次数
全文


摘要